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WK TOTS TO TEENS PEDIATRIC CENTER
NPI 1063769255
Pediatrics in Shreveport, LA

Active since August 07, 2012CLIA 19D2045789 · Accreditation
845 OLIVE ST, SUITE A, SHREVEPORT, LA 71104(318) 226-4892(318) 227-4927 Get Directions Write a Review

NPPES record last updated: August 7, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wk Tots To Teens Pediatric Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WK TOTS TO TEENS PEDIATRIC CENTER (NPI 1063769255) is a healthcare organization registered as a pediatrics in Shreveport, Louisiana and active in the NPI registry since August 2012. The organization holds an CLIA Accreditation certificate valid through May 7, 2027 and lists Greg J Gavin, Network Administrator, as its authorized official.

NPPES Registry Identity

NPI1063769255
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWK TOTS TO TEENS PEDIATRIC CENTER
Location Address845 OLIVE ST, SUITE AShreveport, LA 71104-2141
Mailing Address845 Olive St, Suite AShreveport, LA 71104-2141 · (318) 226-4892 · Fax (318) 227-4927
Phone(318) 226-4892
Fax(318) 227-4927
Organization SubpartNo
Authorized OfficialGreg J GavinNetwork Administrator · (318) 212-4232
Enumeration DateAugust 7, 2012
✔ NPI 1063769255 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
845 OLIVE ST, Shreveport, LA 71104
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 19D2045789

Wk Tots To Teens Pediatric Center · Shreveport, LA
Active · expires May 7, 2027
CLIA Number19D2045789
Laboratory TypePhysician Office
Certificate Effective DateMay 8, 2025
Certificate Expiration DateMay 7, 2027
Laboratory DirectorStacey Flippo
Laboratory Phone(318) 226-4892
Laboratory LocationWk Tots To Teens Pediatric Center845 Olive Street, Shreveport, LA 71104
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAMONA DSOUZA MD
Pediatrics
845 OLIVE ST, SUITE A
SHREVEPORT, LA 71104
Caddo Parish (318) 226-4892
MR. DAVID J CLEMONS MD
Dermatology
845 OLIVE ST
SHREVEPORT, LA 71104
Caddo Parish (318) 222-3278
STACEY D SPARKS MD
Pediatrics
845 OLIVE ST
SHREVEPORT, LA 71104
Caddo Parish (318) 226-4892
MR. DONALD I POSNER
Dermatology
845 OLIVE ST
SHREVEPORT, LA 71104
Caddo Parish (318) 222-3278
DR. JASON JUDE ROMERO MD
Dermatology
845 OLIVE ST
SHREVEPORT, LA 71104
Caddo Parish (318) 222-3278
MR. JACK S RESNECK MD
Dermatology
845 OLIVE ST
SHREVEPORT, LA 71104
Caddo Parish (318) 222-3278
SHEYENNE W CARPER MD
Pediatrics
845 OLIVE ST, SUITE A
SHREVEPORT, LA 71104
Caddo Parish (318) 226-4892

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wk Tots To Teens Pediatric Center's NPI number?

The NPI number for Wk Tots To Teens Pediatric Center is 1063769255. It was assigned to this organization in the NPPES registry on August 7, 2012.

Where is Wk Tots To Teens Pediatric Center located?

Wk Tots To Teens Pediatric Center is located at 845 Olive St Suite A, Shreveport, LA 71104. The listed phone number is (318) 226-4892.

What is Wk Tots To Teens Pediatric Center's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Wk Tots To Teens Pediatric Center hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 19D2045789) is associated with this NPI, valid through May 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Wk Tots To Teens Pediatric Center accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter from Superior HealthPlan and Blue Cross and Blue Shield of Louisiana and 1 other insurer list Wk Tots To Teens Pediatric Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wk Tots To Teens Pediatric Center was last updated on August 7, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.